Insurance Claims Examiner
2 weeks ago
eTeam Inc. is seeking a highly skilled Billing Review Specialist to join our team.
Job Summary:The Billing Review Specialist will be responsible for ensuring that all assigned reviews and company projects are completed timely and accurately according to the scope of work. This includes reporting any issues or concerns to the Supervisor of the Centralized Billing Review team and/or Manager of the Centralized Billing Review team.
Key Responsibilities:- Review and Verify Insurance Claims: Ensure that all assigned reviews and company projects are completed timely and accurately according to the scope of work.
- Communicate with Payors: Contact payors at times to discuss policy criteria or to ask clarifying questions on accounts.
- Understand Payor Requirements: Understand payor requirements according to their policies.
- Collect and Verify Billing Information: Ensure completion of all forms and collect complete billing information.
- Pursue Medical Coverage Updates: Pursue, maintain, and communicate medical coverage/guideline changes/updates.
- Verify Insurance Benefits: Verify insurance benefits and eligibility for patients.
- Communicate with Patients: Communicate with patients to resolve billing issues and ensure timely payment.
- Maintain Accurate Records: Maintain accurate and up-to-date patient records in compliance with HIPAA regulations.
- Work Assigned Reports: Work assigned reports accurately and timely.
- Facilitate Interoffice Communication: Help facilitate interoffice communication on payor updates and trends.
- Complete Adjustments/Transfers: Complete any adjustments/transfers of AR as required.
- Document Activity: Document all activity in customer's computer account or applicable applications.
- Answer Billing Review Specialist Questions: Answer billing review specialist questions accordingly.
- Report Issues: Report issues and/or concerns in a timely manner.
- Assist Team Members: Available to assist other billing review specialists on the team with questions or needs.
- Liaison between Staff and Management: Acts as liaison between staff and management.
- Education: High School Diploma or General Education Degree (GED) Required
- Insurance Qualifications: Past performance shows solid evidence of insurance qualifications and guidelines.
- Communication Skills: Knowledge of telephone etiquette and adequate oral and written communication skills.
- Multitasking Skills: Shows effective multitasking skills.
- Attitude: Positive and cooperative attitude in working and communicating with individuals at all levels of the organization.
- Medical Field Knowledge: Knowledge of medical field preferred.
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